Osteoid osteoma of the foot and ankle-A systematic review

- Commonest in males under 30 years of age affecting the talus.
- Clinical features include night pain and a good response to NSAIDs but diagnosis is typically delayed.
- CT scan is the most useful radiological investigation with MRI missing the diagnosis in 34% of cases.
- Thermal destruction techniques are becoming increasingly used over the last 5 years.

BackgroundOsteoid osteomas are responsible for 10% of benign bone tumours. Treatment typically involves surgical excision or radio frequency ablation. The aim of this systematic review is to evaluate reported cases of foot and ankle osteoid osteomas.MethodsWe conducted a systematic review of the literature using the online databases Medline and EMBASE. We included studies reporting osteoid osteoma diagnosed either radiologically or histologically.Results94 studies were included reporting 223 cases; 70.5% were male, mean age was 23 years, 69% reported night pain and 72% responded to NSAIDs. The commonest affected bone was the talus. CT scan was the most useful radiological investigation and MRI missed the diagnosis in 34% of cases. The majority of patients underwent surgical excision but an increasing trend of ablation therapy was demonstrated.ConclusionsA high index of suspicion based on salient history and appropriate imaging are essential for timely identification and treatment.